Individual
MARTIN IKEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
1860 NW 118TH ST, SUITE 100, CLIVE, IA 50325-8278
(515) 778-4378
Mailing address
1625 ADVENTURELAND DR, SUITE B, ALTOONA, IA 50009-2237
(515) 778-4378
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-13-13506
—
103T00000X
Psychologist
Primary
00808
IA
Other
Enumeration date
01/28/2013
Last updated
07/25/2013
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